The Golden State’s New Scholarship Plan
In a bid to boost their efforts in offering mental health services, California has suggested a scholarship program for mental health workers. This proposal has given rise to debate, with people questioning whether the focus should be on the new court-ordered treatment program or on solving the existing labor shortage in behavioral health services.
The program, termed the Community Assistance, Recovery, and Empowerment Act (CARE Act), involves nine counties. State Governor Gavin Newsom enacted the law in 2022 to navigate people struggling with untreated schizophrenia or other psychotic disorders into treatment. Many of these individuals are homeless or incarcerated.
Challenges in Implementing the CARE Act
Scott Kennelly, Director of the Butte County Behavioral Health Department, voices concerns about the program. The strain lies in the limited resources and workforce, coupled with high expectations for the counties to solve problems such as homelessness.
The law intended to create an annual scholarship fund for students opting for a career in mental health. In exchange, students should work for three years with CARE Court. The bill, proposed by state Sen. Tom Umberg, initially called for a $10 million budget for the program.
Umberg, a Democrat from Santa Ana, argues that CARE Court requires specific funding due to it being a new program. He supports his argument by pointing out that the state offers other scholarships for students pursuing a behavioral health degree.
Umberg underlined the need for more professionals skilled in handling cases related to schizophrenia. However, local health administrators counter that channeling experts into CARE Court may cause shortages in other vital programs. Unmet staffing needs in other sectors of mental health services could exacerbate if experts are shifted to CARE Court.
The CARE Act’s Functionality
According to the new act, patients or their relatives, or even other behavioral health care providers can seek county court’s assistance. Those who provide their consent can receive treatment for up to 24 months. This includes substance use disorder treatment, stabilization medication, and access to social services and housing.
The program’s target beneficiaries are the state’s 181,000 homeless people. The aim is to provide housing without resorting to mandatory conservatorships. Estimates show that about 7,000 to 12,000 Californians could be eligible for CARE Court treatment.
California’s Commitment to Behavioral Health
The state has dedicated $251 million towards staffing and launching the CARE program. Of this, $122 million has been deployed as grants to the counties.
While acknowledging the benefits of the CARE Court program, opponents like ACLU California Action, Mental Health America of California, and some counties argue that scholarships should also benefit other mental health programs in the county.
On the Ground Reality
County behavioral health departments are estimated to be running 25%-30% below full staffing capacity on average. Hiring has proven challenging, with competition from sectors such as education, corrections, and private companies that can offer better salaries, telecommuting options, and ample vacation time.
Finding a suitable clinician for CARE Court is a challenge, requiring individuals comfortable working in homeless encampments and other challenging environments.
The program currently has nine counties that have received over 600 petitions in the first 10 months. However, the remaining 49 counties plan to roll out their programs by the end of the year.
Early successes include San Diego County, which is already transitioning patients out of the court system after a year. However, the funding for the bill could present a significant hurdle in its enactment. Governor Newsom, who earlier closed a $46.8 billion deficit, has until the end of the month to sign or veto the bill.